Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, and Collaborative Innovation Center of Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China.
Department of Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
J Cancer Res Clin Oncol. 2023 Sep;149(11):8863-8875. doi: 10.1007/s00432-023-04828-6. Epub 2023 May 6.
The objective of this research was to assess the utility of positron emission tomography combined with computed tomography (PET/CT) to detect bone marrow invasion (BMI) and the predictive value of PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) patients.
This multicentre study enrolled ENKTL patients who underwent pretherapy PET/CT and bone marrow biopsy (BMB). The specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) of PET/CT and BMB for BMI were evaluated. Multivariate analysis was used to identify predictive parameters for constructing a nomogram.
Seven hundred and forty-eight patients were identified from four hospitals, with eighty (10.7%) having focal skeletal lesions on PET/CT and fifty (6.7%) having positive BMB. When BMB is considered as the gold standard, the specificity, sensitivity, PPV, and NPV of PET/CT for diagnosing BMI were found to be 93.8%, 74.0%, 46.3%, and 98.1%, respectively. PET/CT-positive individuals showed significantly worse OS than PET/CT-negative patients in the subgroup of BMB-negative cases. The nomogram model created according to the significant risk factors from multivariate analysis performed well in predicting survival probability.
PET/CT offers a superior degree of precision for determining BMI in ENKTL. A nomogram model including the parameters of PET/CT can predict survival probability and may help in applying appropriate personalized therapy.
本研究旨在评估正电子发射断层扫描（PET）与计算机断层扫描（CT）联合应用（PET/CT）对骨髓侵犯（BMI）的检测效能，以及在结外自然杀伤/T 细胞淋巴瘤（ENKTL）患者中，PET/CT 的预测价值。
本多中心研究纳入了接受治疗前 PET/CT 与骨髓活检（BMB）的 ENKTL 患者。评估了 PET/CT 和 BMB 对 BMI 的特异性、敏感性、阴性预测值（NPV）和阳性预测值（PPV）。采用多变量分析确定构建列线图的预测参数。
从四家医院共鉴定出 748 例患者，80 例（10.7%）患者在 PET/CT 上存在局灶性骨骼病变，50 例（6.7%）患者的 BMB 为阳性。当以 BMB 为金标准时，PET/CT 诊断 BMI 的特异性、敏感性、PPV 和 NPV 分别为 93.8%、74.0%、46.3%和 98.1%。在 BMB 阴性病例亚组中，PET/CT 阳性患者的 OS 显著差于 PET/CT 阴性患者。根据多变量分析确定的显著风险因素构建的列线图模型在预测生存概率方面表现良好。
在 ENKTL 中，PET/CT 对 BMI 的检测具有更高的准确性。包含 PET/CT 参数的列线图模型可预测生存概率，可能有助于实施适当的个性化治疗。
